Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Orthopedics
Volume 2014, Article ID 937342, 5 pages
http://dx.doi.org/10.1155/2014/937342
Case Report

Use of the Composite Pedicled Pectoralis Minor Flap after Resection of Soft Tissue Sarcoma in Reconstruction of the Glenohumeral Joint

1Department of Orthopaedics, LUMC, Albinusdreef 2, 2300 RC Leiden, Netherlands
2The Oxford Bone and Soft Tissue Tumour Service, Nuffield Orthopaedic Centre, Oxford, UK

Received 31 October 2014; Accepted 14 December 2014; Published 31 December 2014

Academic Editor: Dimitrios S. Karataglis

Copyright © 2014 Michiel A. J. van de Sande et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The surgical repair of an extensive anterior glenohumeral soft tissue defect is complicated by glenohumeral instability and subsequent significant functional deficit. This surgical note offers a relatively simple reconstruction of the anterior capsule and subscapularis muscle using a pectoralis minor pedicle flap. This reconstruction is supplemented with functional reconstruction of the anterior glenohumeral joint. A conventional deltopectoral approach is utilized and pectoralis minor is freed from its coracoid insertion, released, and mobilized without compromising the pedicle entering from the dorsum and inferior one-third of the muscle. The mobilized pectoralis minor vascular pedicle has sufficient length for the pectoralis minor to be transferred to provide coverage of the anterior shoulder joint even in full external rotation, providing anterior stability. To further improve glenohumeral stability and shoulder function, the pectoralis major muscle can be split with the clavicular part reinserted lateral to the bicipital groove onto the lesser tuberosity replacing subscapularis function while stabilising the glenohumeral joint.